Aim: Hepatocellular carcinoma(HCC) is the most common primary malignant tumor of the liver. The incidence of HCC has increased in Van region due to high prevalance of hepatitis B. This study has aimed to analyse and compare the features of hepatocellular carcinoma and decompansated liver cirrhosis. Methods: This study was performed by prospectively analysis of 39 patients with HCC and 36 patients with decompansated cirrhosis who had attended the gastroenterology clinic of Yuzuncu Yıl University Hospital between 2002 and 2005. The mean age of total cases was 53. Charactheristics of demographic features were recorded and diagnostic tests were performed . The data was analysed using the Anova analyse and chi square test. Results: We classified the patients with HCC as group 1 and the patients with decompansated cirrhosis as group 2. In both groups, male predominance was observed . 82 percent of the HCC cases and 92 percent of the cirrhotic cases had hepatitis B . Platelet counts, sedimentation rate,alpha fetoprotein and alkalen phosphatase levels were elevated in group 1 than those in group 2 and a statistically significant difference was observed between two groups.(p<0,001; p<0,005; p<0,001; p<0,05). Serum ıron levels and prothrombin time were found to be lower among the cases with HCC ( p<0.05 ). Approximately half of hepatocellular carcinomas were limited to the right lobe of the liver and 61% of HCC lesions were larger than 5 cm. Conclusion: This study points the role of platelet counts, sedimentation rate, alpha fetoprotein, alkalen phosphatase and serum iron levels and prothrombin time for HCC screening especially in patients with decompansated cirrhosis.

The most important causes of fulminant hepatitis are HDV-HBV coinfection or superinfection. HBsAg positive 184 males were involved in this study. Sera values of HBV and HDV were evaluated by ELISA. According to the results 36 (19.5%) of the 184 HBsAg positive sera were evaluated as anti-HDV positive. The rate of coinfection of acute HBV and HDV was detected as 7.69% ( 39 of the sera were detected as anti-HBc IgM positive, 3 of them are detected as anti-HDV IgM positive). The rate of HDV superinfection added to chronic HBV infection was detected as 24.8% (36 anti-HDV total IgM+IgG positivity/ 145 anti-HBC total IgM+IgG positivity).

Aim: To date hearing loss after spinal anesthesia has been examined subjectively by pure tone audiometry. In this paper the evaluation of hearing loss was objectively investigated with otoacoustic emissions also. Methods: In a prospective and randomised study at a teaching hospital, 30 male patients admitted for lower extremity operations were enrolled. Spinal block was achieved with 25 G Quincke needle at the L3-4 interspace and 3 mL of 0.5% hyperbaric bupivacaine. Hearing tests pure tone audiometry and otoacoustic emissions were performed twice for every patient: preoperatively and postoperatively. p<0.05 was considered statistically significant. Results: Only one patient experienced clinically significant (30 dB) hearing loss and subclinic hearing loss (10-25 dB) was recorded as 20%, according to the results of pure tone audiometry. However, otoacoustic emissions revealed that at least 30 dB hearing loss occurred in totally 11 ears of the 30 patients. Conclusion: Hearing loss may be detected objectively and earlier with otoacoustic emissions compared with pure tone audiometry.

Aim: We aimed to evaluate the rates and clinical properties of tumors in the patients with non-melanotic skin cancer who were admitted to Van Yüzüncü Yil University, Department of Plastic and Reconstructive Surgery. Materials and Methods: Between 2003 to 2006, files of the patients who were managed for non-melanotic skin cancer in our clinics were retrospectively reviewed and types and locations of the tumors, and ranges of age were recorded. Results: Of 115 patients who were diagnosed as non-melanotic skin cancer, 86 (74%) had Basal Cell Cancer (BCC), and 27 (23,5 %) had Squamous Cell Cancer (SCC). There were Mycosis Fungoides and Dermatofibrosarcoma Protuberans in one each patients. Of our series, 76 (66 %) were male and 39 (34 %) were female. Age of the patient ranged from 13 to 106 years (average, 60). The head and neck was most frequently involved region in the groups of BCC and SCC with the rates of 98 % and 89 %, respectively. Conclusion: Most of the patients who were managed for skin cancer in Van Yüzüncü Yil University, Department of Plastic and Reconstructive Surgery, were diagnosed as BCC. Required precautions should be taken to avoid the skin cancers in Van where is the most sunny region following Antalya in Turkey.

Herpes encephalitis is the most frequent one of all encephalitides with the highest mortality. It has a mortality rate of 70% if not treated. However if the treatment is started before the patient does not lose his consciousness, the success rate is 92%. In this paper, a case admitted to our clinic after becoming unconscious and diagnosed with encephalitis by establishing herpes simplex virus DNA in his cerebrospinal fluid by PCR is presented. Severe motor mental sequel remained in the patient who was treated with acyclovir for 21 days.

A 61-year-old woman was admitted to the department of neurology in our hospital. She had a stroke (left hemiparesis) without any sequela. The blood pressure was 130/80 mmHg with irregular pulse rate of 107/min. A diastolic rumbling was audible over the apex. She had Transtorasic Echocardiography for search source of emboli. TTE revealed mitral valve stenosis (0,9 cm2) with a peak gradient of 15 mmHg and a mean gradient of 7 mmHg across the valve. TEE disclosed the presence a giant thrombus in the left atrial appendage. Mitral valve surgery was suggested to the patient. At operation, atrial thrombectomy and radiofrequency ablation commenced prior to valvular procedure. Then the calcified valve leaflets were excised and replaced with 29 mm bileaflet mechanical mitral valve prosthesis. Postoperative recovery was uneventful and discharged to home. In conclusion, left atrial thrombosis due to rheumatismal mitral valve disease should be kept in mind in patients with neurological deficit and atrial fibrillation.

Obesity is an important and chronic disease. It occurs due to more body fat accumulation than normal levels. It associates with many factors and it needs to medical treatment. Important risk factors of obesity are feeding habits, sexuality (female), age, education, marriage, labor number and hereditary. Obesity, may be originated from hereditary factors and it progresses very fastly in developed and developing countries. More than 30 % percent of population is obese in Turkey (male %7,9 female %23,4). It is known that obesity is closely related with many chronic disorders. Thus, well knowledge about effects of obesity and its alternative treatments is important for determining ideal treatment of obesity and its complications. Aim of this review is to represent effects causing obesity and its treatment options together.